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What Is It

Also known by its Chinese name Ma huang, ephedra is made from the dried stems of Ephedra sinica, a shrub native to desert regions of Asia. However, preparations from species such as E. intermedia or E. equisetina may also be effective. A synthetic version of ephedra's active ingredients is widely used in both prescription and over-the-counter drugs, including hundreds of cold, allergy, asthma, weight-loss, and energy-boosting formulas. Unfortunately, the herb has been abused in recent years, when some people began taking very high doses as a recreational stimulant FDA considered banning the supplement in 1996.Though a ban was not imposed, the FDA has since proposed that all ephedra preparations carry a warning label.

What Does It Do

Ephedra's primary active ingredients, the chemicals ephedrine and pseudo-ephedrine, have two major effects: They stimulate the central nervous system and they open the airways. Ephedra's stimulant effect is stronger than that of caffeine, but less potent than that of amphetamines or that of the natural adrenal hormone epinephrine (adrenaline), which prepares the body for stressful situations (the "fight-or-flight" response).

Ephedra makes the heart beat faster, increases blood pressure, speeds up the metabolism, and acts as a diuretic. But throughout its long history its main use has been as a bronchodilator, to treat the bronchial and nasal congestion of asthma, allergies, colds, and sinus infections. In the 1920s, U.S. drug companies began extracting active ingredients from the herb and using it in asthma and cold medicines. A practice that many companies still follow today.

Common Uses

Aids in weight loss, suppresses appetite.

Eases congestion and labored breathing that are caused by allergies or asthma.

Relieves pressure and congestion in sinus infections (sinusitis).

Major Benefits

Ephedra dilates the small airways in the lungs (the bronchioles), which helps relieve congestion and coughing due to seasonal allergies or to mild asthma. It also plays a role in alleviating respiratory symptoms caused by colds, flu, and sinus infections.

Additional Benefits

Some weight-loss supplements claim that ephedra, usually in combination with St. John's wort, is an "herbal fen-phen," a natural alternative to the antiobesity prescription drugs fenfluramine (now banned for possibly causing heart disease) and phentermine. Though ephedra may make the body burn calories quickly and suppress appetite, studies of this herb as a weight-loss aid have been contradictory. For those in otherwise good health, it is considered safe and effective in recommended doses.

More controversial is the claim that ephedra enhances athletic performance by boosting energy. Not only is there no scientific basis for this theory, but it has had tragic consequences: A number of athletes have become seriously ill, and several have died after taking large doses of products containing ephedra. The herb is currently listed as a banned substance by the U.S. Olympic Committee.

How To Take It

Dosage: Check your bottle's label to see how much ephedrine is contained in each dose of ephedra. Most standardized extracts supply about 5.5% to 6.5% ephedrine (also known as "ephedra alkaloids"). Begin with a low daily dose, such as 100 mg of ephedra (about 6 mg of ephedrine). If side effects aren't a problem, increase the dose, but don't exceed (30 mg of ephedra (about 8 mg of ephedrine) three times a day.
To make a tea, pour 1 cup of very hot water over 1 teaspoon of dried ephedra (along with other herbs if desired) and steep for 10 to 15 minutes; drink one or two cups a day. Or take .25 to 1 teaspoon ephedra tincture (up to 8 mg of ephedrine) in a glass of water up to three times daily.
Guidelines For Use: Check with your doctor before using ephedra, especially if you have heart disease, diabetes, or other medical problems, or if your symptoms do not improve. Never exceed the recommended dose. This herb can be taken long term for certain conditions, such as chronic asthma, but try to use it only as needed. Ephedra may be safely combined with many other herbs, including St. John's wort. But avoid taking it with caffeine, which can cause excessive stimulation. If it promotes insomnia, omit your evening dose.

Possible Side Effects

The higher the dose and the longer you take ephedra, the greater the incidence of such common side effects as nervousness, insomnia, heart palpitations, and paleness. Less often there may be dizziness, tingling, nausea and vomiting, loss of appetite, muscle cramps, headache, and difficult or painful urination. Extremely serious side effects include high blood pressure, stroke, seizures, and with very high doses, hallucinations and psychosis.

Caution!

Ephedra can cause blood pressure to soar. Check with your doctor if you have high blood pressure, heart disease, or heart rhythm disorders or take MAO inhibitors for depression.

Ephedra can elevate blood sugar. People with diabetes should use it with caution.

Talk to your doctor if you have thyroid disease, difficulty urinating from prostate problems, or are pregnant or breast-feeding.